Preventive services differ between primary care docs and OB/GYNs

NEW YORK (Reuters Health) - The services women receive
during annual preventive care visits may partially depend on
what type of doctor they see, suggests a new report.

Women who saw primary care doctors for their annual checkup
tended to receive a broader range of services, compared to those
who saw obstetrician/gynecologists (OB/GYNs), researchers found.

"I think (primary care providers) and OB/GYNs can play an
important role in clinical preventive services," said Dr. Mona
Saraiya, one of the study's authors. "I think it's important to
be aware where there might be deficits."

Saraiya is an associate director within the Division of
Cancer Prevention and Control at the Centers for Disease Control
and Prevention in Atlanta.

She and her co-authors write in JAMA Internal Medicine that
well-woman preventive care visits are a core service supported
by the U.S. Health Resources and Services Administration (HRSA).

Well-woman visits should occur every year for women to get
the recommended preventive services, which include blood
pressure checks, tests for sexually transmitted infections and
cancer screenings, according to HRSA.

For the new study, the researchers analyzed medical records
from between 2007 and 2010 to see what services women typically
receive during a well-woman visit with a primary care doctor
compared to an OB/GYN.

They had data on about 281 million medical visits that
occurred during that time. Of those, about 63 million were for
preventive care.

The researchers found that 44 percent of preventive care
visits were to OB/GYNs and 56 percent were to primary care
doctors.

Women who were 50 years old or older were more likely than
younger women to see a primary care doctor for their preventive
care.

Saraiya and her colleagues found that women who saw OB/GYNs
were more likely to get screened for cervical and breast
cancers, Chlamydia and osteoporosis, compared to those who went
to primary care doctors.

Those who went to primary care doctors were more likely to
get screened for colon cancer, high cholesterol and diabetes and
to be counseled about diet, exercise and obesity, however.

The researchers could not assess how often doctors counseled
women about contraceptives because of limitations with the data.

Counseling for other health matters, such as smoking, was
low among women who went to either OB/GYNs or primary care
doctors.

Because women who went to primary care doctors tended to
receive a wider range of services, the researchers write that
"women of reproductive age who see OB/GYNs only for preventive
care may not be receiving the full spectrum of recommended
screening and counseling."

Saraiya said there could be room for OB/GYNs to provide more
services to fill in any gaps. Also, primary care doctors in
rural areas may be able to provide more services when OB/GYNs
are not easily accessible.

The American Congress of Obstetricians and Gynecologists
(ACOG) does not have an official statement about whether OB/GYNs
should also serve as primary care providers. It does endorse
annual well-woman visits, however.

A spokesperson for ACOG wrote in an email to Reuters Health
that most state Medicaid programs recognize that OB/GYNs play a
part in primary care.

Saraiya said it will be useful to go back and look at
additional data to see if there are changing trends in the
preventive services women receive.

"We want to make sure we document where there could be room
for improvement," she said.